Patients Push Their Own Pills

Yet the Orange County woman kept selling her prescription painkillers from her front porch to make ends meet, said the deputy who jailed her for the illegal sales.

A 34-year-old hemophiliac who has AIDS sells his pills by telephone. He keeps the addicts' names in a notebook, and he lives with his pain by smoking marijuana.

How much he sells depends on how much pain he can handle. Sharing his prescriptions with drug dealers and users, he said, pays his doctor bills.

County, state and federal law enforcement officials suspect that similar scenes are being played out daily in Central Florida, where sick people can get up to $75 a pill by illegally selling their painkillers, tranquilizers and sedatives.

Although no statewide monitoring system tracks the illegal dealing of prescription drugs, investigators suspect that the number of patients selling their drugs is on the rise.

They say they have seen evidence of this in the increased trafficking in Central Florida of high-morphine painkillers, such as Dilaudid, over the last two years.

Dilaudid, which has properties similar to heroin and can be addictive, carries higher criminal penalties for illegal possession and sales than other prescription drugs. It usually is used only in hospitals or in homes with terminally ill patients, said Dr. Antonio Certo, a pain specialist in Winter Park who said he never prescribes the drug.

''Dilaudid should send up a red flag'' to agents who discover it on the streets, he said.

Agents who have made several arrests for the dealing of Dilaudid in the last two years believe addicts have been turning to patients for their supplies. They say that's because of a crackdown in the last decade on other sources of high-morphine drugs, such as pharmacy burglaries and prescription forgeries.

Doctors and dentists also have been taking more care to avoid schemes of those illegally seeking prescriptions, they say.

''The whole professional community has wised up (to scams) in the last 10 years,'' said Doyle Jourdan, special agent in charge of the Florida Department of Law Enforcement in Orlando.

Doctors are more careful when prescribing medications, and they keep an eye on their prescription pads. Some have switched to color-coded pads that cannot be photocopied, or they write them in triplicate.

Central Florida pharmacists keep track of patients and the frequency of their prescriptions through a computer network. To avoid confrontations with people claiming to be patients, many pharmacies have even stopped carrying Dilaudid and other high-powered painkillers, tranquilizers and sedatives, Jourdan said.

Cooperation from doctors and pharmacists has helped agents arrest drug dealers who use scams to try to get prescription drugs. Some, for example, feign illness and go to a doctor's office, where they steal prescription pads. Later, the dealers forge and fill phony prescriptions.

Agents from the Metropolitan Bureau of Investigation, a multi-agency drug and vice task force, have made several arrests over the last two years for sale and delivery of Dilaudid, said director Joe Cocchiarella.

Last November, Orange County deputy sheriffs arrested two men on charges of sale and delivery of Dilaudid, Detective Eric Fortinberry said.

The people who supplied the Dilaudid in those cases remain a mystery.

A network of people who are sick or who know a sick person are dealing Dilaudid and other high-morphine drugs, Fortinberry said. The typical user, he said, is older and experimented with drugs in the 1960s that, like Dilaudid, were depressants.

''We're talking big problem in the last two years. Everyone we've dealt with so far is at least 35 years of age,'' said Fortinberry, part of a team that recently completed a five-week investigation into the problem.

Police spend little time investigating prescription drug abuse because establishing contacts with dealers is difficult and because cocaine and marijuana are considered a more dangerous and widespread problem, Cocchiarella said.

Agents don't find it cost effective to spend time investigating people who sell handfuls of pills, rather than kilos or grams of drugs, as in the case of cocaine and marijuana trafficking, he said.

Prescription drug suppliers also are difficult to ferret out and catch.

They generally work out of their homes or in hospitals, rather than on the streets, agents believe.

''This is not curb-side stuff,'' said Fortinberry.

The hemophiliac said the agents' description of dealers fits several he has known.

''I used to go down to this lady's house, she must have been 55 years old, and she'd reach on top of her refrigerator for a Tupperware bowl'' for the drugs she was selling out of her home, said the hemophiliac.

''It's hard (for police) to get a hold of these people,'' he said.

Dealers are ''ashamed of it, and they only sell to people they know or relatives. They don't want anybody to find out they're doing it, so they keep it to a minimum,'' he said.

The person with the prescription is not always the one who deals the drugs. And it is difficult to prove that someone with a partially used prescription bottle knew that his drugs had been sold.

Three years ago, a northeast Orange County construction worker bought Dilaudid from a co-worker whose wife was dying of cancer.

''His wife couldn't use them anymore - they were too strong, they made her sick. So the best thing to do was go ahead and invest that $30 for a batch of pills, and turn around and sell them at $40 apiece,'' the construction worker said.

''I don't think he ever told her because he didn't have the heart. He had mounting medical bills. All profits he poured right back into her.''